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Incontinence not a topic men talk about.

Posted May 25 2012 7:21am

We know that incontinence is not a topic most men are comfortable talking about … or even thinking about. Get a group of men together and the only plumbing problems you’ll hear about are the external, kitchen-sink variety. “It is a big problem for men, especially men who have ever undergone prostate surgery or prostate cancer operations or treatment,” said Dr. Andrew E. Bourne, an American urologist.

Bourne called it the “rule of men,” that they are strong and don’t want help, whatever the problem. “We don’t often seek medical advice for anything, whether it’s general medical problems or things that really bother us, like wetting our pants,” he said. “So we try and avoid those things, and we try and not discuss this with anybody, and there is a lot of embarrassment that goes along with it and a lot of discomfort.”

But eventually the need for help outweighs the embarrassment, Bourne said. While most of his patients are elderly men, incontinence can affect all men. It is, he said, one of the most common side effects of all prostate cancer treatments and the most common side effect of prostatectomy, with 39 to 63 per cent of prostate cancer patients experiencing some level of urinary incontinence for one year after surgery.

So the more educated you are about your urinary incontinence , the better off you are when it comes to managing it, Bourne said.

There are three different kinds of incontinence, stress , urge and overflow, with some combination also possible. Stress incontinence comes when bearing down, coughing or pressure on the abdomen causes urinary leakage. Urge incontinence involves an unwanted bladder contraction that causes leakage. Overflow incontinence comes when the bladder doesn’t empty and the urine is squeezed out bit by bit just because your bladder has reached capacity.

Bourne said there is also mixed urinary incontinence, a mixture of stress and urge incontinences. “And then sometimes we discuss things such as insensible incontinence, where a person just has no idea what type of incontinence they have due to lack of sensation,” he said.

While prostate problems are most often to blame for male incontinence, men can have overactive bladders, just like women, which can lead to urge incontinence, Bourne noted. “Something called interstitial systitis can cause symptoms of the bladder, leading to incontinence. And that does occur in men less frequently than in women,” he said. “Also, you can have neurologic problems. Men who have strokes, spinal cord injuries, different neurologic disorders, diabetes, things that affect the nervous system to the bladder and the sphincter that controls the urinary stream, whether stopping or starting or involuntarily holding your urine, that can be affected by any nervous abnormality.”

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